Tokat Merkez

Researchers are evaluating AZD0780, an oral PCSK9 inhibitor, in a phase 3, randomized, placebo-controlled study to see if it can reduce the risk of major adverse cardiovascular events (MACE-PLUS) in adults with established atherosclerotic cardiovascular disease (ASCVD) or those at high risk for a first ASCVD event. The study compares AZD0780 to a placebo and monitors participants from randomization until the primary analysis censoring date, followed by a final study closure visit. Participants will be randomly assigned to receive either oral AZD0780 or an oral placebo once daily. The treatment period lasts until the primary analysis censoring date, after which a study closure visit will occur. The study is event-driven and designed to assess the time to the first major cardiovascular event during treatment. During the study, participants will be closely monitored with various assessments to evaluate cardiovascular outcomes and safety over approximately 54 months. Researchers will track the time to first event of any component of MACE-PLUS and collect data to assess the effect of AZD0780 compared to placebo. The study includes regular visits and evaluations to ensure participant safety and adherence to treatment.

Researchers are evaluating how an education program based on the ARCS Motivation Model affects nursing students' communication skills, learning motivation, and self-confidence. Communication is vital in nursing for delivering quality patient care and ensuring safety, yet nursing students often struggle with these skills. The ARCS model focuses on Attention, Relevance, Confidence, and Satisfaction to boost motivation and improve learning outcomes. This study uses a randomized controlled design to compare the ARCS-based training with traditional education among first-year nursing students. The study divides participants into two groups: an experimental group receiving ARCS Motivation Model education and a control group receiving standard education. The ARCS training is delivered through teaching materials and group activities emphasizing the model's four components. The intervention aims to enhance communication and motivation during the nursing students' clinical practice period. Participants are assessed using scales measuring communication skills, learning motivation, and self-efficacy both one week before and two weeks after the training. Data collection includes demographic information and standardized questionnaires. Researchers will examine changes in these outcomes to understand the training's effectiveness. Participation requires attending all sessions, and students are monitored for adherence throughout the study period.

Researchers are evaluating whether ziltivekimab can help people who were hospitalized due to a heart attack by potentially reducing the development of heart disease and preventing new heart attacks or strokes. This Phase 3 study compares ziltivekimab with a placebo, which is a dummy medicine that has no effect on the body. Both treatments are given by chance, with equal likelihood for participants to receive either ziltivekimab or placebo. Participants will inject the study medicine once a month under the skin in the stomach, thigh, or upper arm. Ziltivekimab is given as an initial loading dose followed by monthly maintenance doses. The placebo group receives a matching injection schedule. The study duration is about two years. During the study, researchers will monitor participants for the time until the first serious heart-related event, including cardiovascular death, non-fatal heart attack, or non-fatal stroke. Participants will be closely observed from the start of randomization up to 25 months. The study includes regular follow-ups to assess safety and effectiveness of the treatments throughout this period.

Researchers are evaluating the effectiveness of two types of peripheral nerve blocks—the suprainguinal fascia iliaca plane block and the adductor canal block—for managing postoperative pain in patients undergoing total knee arthroplasty with spinal anesthesia. This study aims to compare these two nerve blocks to understand their impact on pain control after surgery. Participants are adults aged 18 to 75 years with an American Society of Anesthesiologists (ASA) physical status of I to III, scheduled for this specific knee surgery. Patients will be randomly assigned to receive either the adductor canal block or the suprainguinal fascia iliaca plane block, both performed by a single investigator under ultrasound guidance. After surgery, patients will be monitored in the recovery room with standard measurements including ECG, blood pressure, heart rate, and oxygen saturation. A patient-controlled analgesia (PCA) pump delivering opioid (tramadol hydrochloride) bolus doses will be used for pain management when pain scores reach 4 or higher. Additionally, all patients will receive routine intravenous paracetamol every 6 hours unless their pain scores are low. If pain persists with a score of 4 or above despite these treatments, rescue analgesia with intramuscular diclofenac sodium will be provided. Throughout the postoperative period, patients will be regularly visited and evaluated by an anesthesiology specialist who is unaware of the nerve block type they received. Assessments will include pain scores measured at multiple time points up to 24 hours after surgery, motor strength of the operated leg, opioid use, need for rescue analgesia, and any complications. This careful monitoring aims to capture detailed data on pain control and recovery over the first day after surgery.

Researchers are evaluating a method called peripheral venous pressure (PVP) measurement to better guide diuretic therapy and predict long-term outcomes such as death, hospital readmission, and emergency visits in patients hospitalized with heart failure. This Phase 4 study aims to improve management of congestion in heart failure patients, who often leave the hospital with persistent fluid buildup, increasing the risk of complications. The trial includes adults aged 18 to 99 with new or worsening chronic heart failure, regardless of heart function or cause. Participants will be randomly assigned to receive diuretic treatment guided either by standard clinical evaluation or by PVP measurements taken through a peripheral intravenous line placed in the arm. The PVP group will target a pressure below 9 mmHg before discharge to guide fluid removal. Blood samples, heart tests including ECG and echocardiogram, and fluid balance assessments will be performed. Those who cannot have PVP measured or need advanced support like dialysis during hospital stay will be excluded from certain parts of the study. During the one-year follow-up, researchers will track major adverse events including death, hospitalizations, and emergency visits. They will also analyze correlations between PVP readings and outcomes, kidney function changes, length of hospital stay, and repeat admissions. Data will be collected electronically and analyzed to compare the effectiveness of PVP-guided therapy versus standard care in managing heart failure congestion.

Researchers are evaluating the effects of Electronic Fetal Monitoring (EFM) training delivered through a peer education method on midwifery students' knowledge, skills, and confidence levels. This experimental study uses a randomized controlled pre-test-post-test design to compare peer tutoring with standard education. The study focuses on second-year midwifery students who have not previously received EFM training and are enrolled in a Prenatal Period I course. All students first receive standard training on EFM. Then, students are randomly assigned to either a Peer Tutoring group, where they learn EFM topics through a structured peer teaching approach involving group discussions and explanations, or a Standard Education group. After peer education, students apply EFM to pregnant women in clinical practice while being observed and evaluated by researchers using a skill form during the approximately 30-minute application. Participants complete several assessments before and after training, including a personal information form, an achievement test for EFM, the Electronic Fetal Monitoring Self-Efficacy Scale, and skill forms during EFM application. These tools measure knowledge, skill performance, and self-efficacy. The self-efficacy scale and achievement test are administered both as pre-tests shortly after standard training and as post-tests within 30 minutes after clinical EFM application. Evaluation continues during clinical practice to monitor progress.

Researchers are evaluating the effectiveness of synchronous telerehabilitation in adults aged 18 to 65 years with elevated pulmonary artery pressure, defined as systolic pulmonary artery pressure of 50 mmHg or higher. This study aims to see if telerehabilitation improves exercise capacity, breathing difficulties (dyspnea), fatigue, functional status, psychological well-being, and quality of life compared to breathing and posture exercises. Pulmonary hypertension is known to reduce physical activity and exercise tolerance, impacting daily life and well-being, and this trial focuses on whether remote rehabilitation can offer benefits for this population. Participants will be randomly assigned to two groups. One group will receive supervised synchronous telerehabilitation via videoconferencing, including aerobic, endurance, and strengthening exercises, performed three times per week for 30 minutes over 8 weeks. The control group will perform breathing exercises, posture techniques, breathing control, and energy conservation strategies along with routine care and weekly motivational follow-up. After the initial 8 weeks, control participants may have the option to join the telerehabilitation program. Participants will be assessed before and after the 8-week intervention. Evaluations include exercise capacity and severity of breathing difficulties using standardized scales. Researchers will also monitor fatigue, physical activity levels, psychological status, pulmonary function, and overall quality of life. The study collects data to understand whether synchronous telerehabilitation is a useful and accessible rehabilitation option for patients with elevated pulmonary artery pressure, especially for those who face challenges attending in-person sessions.

This research aims to assess how different deproteinizing agents affect the success of non-invasive fissure sealant treatments in permanent teeth. Fissure sealants are used to prevent tooth decay or stop early decay limited to the enamel on tooth surfaces at high risk for cavities. This study is pioneering in evaluating the clinical success of using hypochlorous acid for deproteinization in these sealants. Participants will receive fissure sealant applications on newly erupted permanent lower first molars without caries. The study involves applying deproteinization agents before the sealant treatment, with follow-up checks scheduled at 6, 12, 24, and 36 months to monitor success. This approach is designed as a split-mouth clinical study, meaning different treatments may be applied to different teeth within the same participant. During the study, researchers will assess the clinical success of the sealants using the Modified Simonsen Criteria at each follow-up visit. They will monitor tooth condition and sealant performance over three years. Participants' behavior and oral health will be observed to ensure accurate results, and adherence to follow-up appointments is required for ongoing evaluation.

Researchers are evaluating how different deproteinizing agents affect the success of fissure sealants in primary teeth. This study focuses on a non-invasive method to prevent cavities or stop the progression of early enamel caries on tooth surfaces that are at high risk. The study is notable for being the first in vivo clinical trial assessing the use of hypochlorous acid as a deproteinizing agent in fissure sealants. The treatment involves applying different deproteinization agents before fissure sealant application on lower second primary molars. The study compares these agents to evaluate their impact on the sealants' clinical success. Since this is a split-mouth clinical study, different treatments may be applied to different parts of the mouth to directly compare outcomes. Participants will be monitored over 3, 6, 12, and 24 months after sealant application to assess success using the Modified Simonsen Criteria. The study involves dental examinations to check sealant effectiveness and integrity. This long-term follow-up helps researchers understand how well the treatments work to prevent caries over time.